Migration and Mental Health

As most of us look forward with hope to 2017, some face uncertainty, risk and stress. 3% of the worlds population live outside their country of origin and around 2 million move each year. Most stable traffic is between developed nations, but occasional mass migrations follow stressors like war and famine.
Moving country is not easy, as I know myself having recently relocated from Scotland to New Zealand. Every year, around 40,000 UK citizens move overseas for several years or more – for us it was a chance to spend some years as a family overseas like my wife and I both did when we were young. I have spent ten months filling in forms, applying for jobs, getting visas and planning the trip itself. On arrival, we had to choose a part of the city to live in, find a school for the boys and buy a car. We then had to wait for ‘the boat’ to arrive containing all our worldy goods in a container crate. I also had two months off work – which sounds wonderful but removes the usual structures on which we rely more than we realise.
Add to this the experience of someone fleeing war or famine. There is no time to prepare, so money and possessions  are usually left behind. Sometimes family members too… Trauma before leaving can cause scars – mental and physical. And the chances are that the country you move to may be less than welcoming, with stigma, paperwork and a language barrier. Makes my planned move to a secure English-speaking job seem like a walk in the park!

Mental Illness in Migrants

Many people make migration journeys with intact mental health, but it has been known for a long time that rates of depression and other ‘neurotic’ illnesses are more common in migrants from poorer countries than the local population.  Migrants between wealthy countries often have good mental health due to extensive screening as part of the migration process.
It is more uncertain whether psychotic illnesses are caused by migration – they are seen at increased rates, but the causes are more complex than just stress. Post-traumatic stress disorder can be increased if coming from a trauma zone but, whilst a more reported illness, it is always at lower levels than more 'everyday' depression.
When illness is present, it can be hard for people to get help due to language barriers, different models of illness and care and, in some countries, the cost of healthcare.

Faith and Migration

Christianity is a migrant faith. From the banks of the Euphrates to Egypt and then the promised land, the people of the Bible were nomadic at the beginning and then enslaved. This is enshrined in Deuteronomy 26v5: “My father was a wandering Aramean”, which is part of a speech to be made when offering first-fruits at the temple and reminds the speaker that they are only there by grace.
Jesus himself was a migrant refugee. In Matthew 2v13-23 we hear how Joseph fled to Egypt with Mary and infant son Jesus after a visit by the Magi, because they learned that King Herod intended to kill all first-born Israelite sons.
migration 1200
The ‘Great Commission’ of Matthew 28v16-20 compels the faith to be spread to ‘all nations’ and in Acts 1v8 we see it prophesied to spread from Jerusalem, through Judea and Samaria to ‘the ends of the earth’.
Whilst some missionaries made specific journeys, staring with St Paul, the spread of the early church was due as much to migration. From the Ethiopian in Acts 8 to the medical missionaries of the last few centuries who moved overseas to build hospitals, people have always moved to share their faith. We are now seeing a geographic reversal as strong Christian communities (such as from Nigeria or South Korea) are coming to the UK and plant churches and convert their indigenous neighbours.
Moving house and home is part and parcel of the Christian story, and it typically sees people go through a faith journey too – trusting God’s promises, stepping out in faith, and seeing His blessings and prayers answered. However, the blessings and answers are rarely what we expect. Typically, God will use these times to teach profound truths. Sometimes, God can seem to be absent, silent, unfair – and faith can be tested to the extreme.

Migration and the Church

Understanding foreign cultures should not be alien to any church. All towns and cities have some degree of ethnic variation. Many churches will also be senders of missionaries – though this practice is becoming [sadly] less common. Some churches will be in an ethnic minority compared to the areas they are in. Some will be close to places chosen by the Government as areas to receive incoming mass-migrants such as from Syria.
Whatever a church’s situation, we can learn from the Bible that it is not ‘them-and-us’, that we are all here in this place by Grace. A hallmark of healthy faith in the Old Testament was how they treated the ‘widow and sojourner’. And we can all echo the prayer of Deuteronomy 26v5 that ‘my father was a wandering aramean’.
As we enter 2017, lets take a moment to remember those whose journey may not be clear or complete:
-- What opportunities are there in the community near you to bless and receive migrants – and be counter-cultural in doing so?
-- What are the ‘them-and-us’ challenges in your area – which is just stigma underneath?
-- Are some of these migrants mentally ill – can you support them to access help in both the church community and through health services?

UK migration data - http://www.migrationobservatory.ox.ac.uk/resources/briefings/long-term-international-migration-flows-to-and-from-the-uk/
UN Migration ‘wallchart’ - http://www.un.org/en/development/desa/population/migration/publications/wallchart/index.shtml
Overview article on migration and mental health - http://apt.rcpsych.org/content/7/3/216

Rob Waller, 01/01/2017
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